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BASCD’s view on the replacement of Public Health England with the National Institute for Health Protection

On the 18th of August 2020 the health secretary Matt Hancock announced a radical change to the orientation of public health services in England. Public Health England (PHE) is to be replaced by the National Institute for Health Protection (NIHP).

Whilst health protection is a fundamental aspect there is so much more to public health.  We as members of BASCD are committed to disease prevention and health promotion and are concerned about the repercussions for dental public health, a specialist area within the public health domain.

We fully support the stance of the British Dental Association who have written an open letter to the health secretary seeking urgent clarification on the role of dental public health going forward.

Dr Robert Witton Chair of the BDA Dental Public Health committee and a BASCD member, in his blog supporting this letter stated:

“Effective management of the pandemic response is a clear national priority. But meaningfully protecting the public long-term hinges on an effective approach to public health, in which oral health is not an optional extra”.

Public health protection is inextricably linked to disease prevention and health promotion – if you compartmentalise these you will lose the synergy of holistic public health. So for example PHE monitors and reports on the health effects of fluoride on people living in areas covered by water fluoridation schemes which ensures that the programmes are safe but also helps prevent one of the most prevalent non communicable diseases, tooth decay.

Furthermore, a focus on health protection alone will lead to a widening of dental health inequalities; without a focus on disease prevention and health promotion  we could see for example increases in the numbers of children requiring dental treatment via general anaesthetic; and the numbers of vulnerable older adults living without adequate mouthcare and oral hygiene affecting their abilities to eat and speak and their dignity and quality of life.

We need to keep the momentum of our national preventive programs supporting supervised toothbrushing with fluoridated toothpaste in nurseries and schools and oral hygiene for care home residents.  The multi-disciplinary work with wider partners such as health visitors, teachers, nutritionists, care home staff could all be lost.

Many dental public health professionals across the UK have been seconded to work, to protect the populations they serve during the Covid-19 pandemic. It would be a pity if their career long commitments to public health promotion and prevention (not merely protection) be thwarted by the introduction of this new agency.

Maria Morgan President elect of BASCD says “Please Mr Hancock don’t throw the baby out with the bath water!”

22nd August 2020